Wouldn’t it be wonderful if there was an 100% natural ingredient that did the work multiple skincare products all rolled into one, and, was all natural, and proven clinically to deliver what was promised? Well there is, and its name is azelaic acid. Nevertheless, what is this natural acid and what does it do that is so amazing. It is a saturated dicarboxylic acid extracted from grains like wheat, rye and barley with the molecular formula C9H16O4. It is also found on the skin being produced by a yeast called Pitysporum ovale. What is amazing about this acid is its ability to act upon a number of skin health related problems, hyperpigmentation, rosacea, and adult acne.

One of the signs of skin aging is the appearance of brown spots or hyperpigmentation. This over production of pigment results from the skins repeated exposure to the damaging effects of the suns UV radiation and in particular the suns’ UVA rays. These “age spots” may also be worsened by the daily exposure of the skin to environmental pollutants and contaminants. Due to the constant exposure to these irritants, the skin reacts by producing increased amounts of the skin pigment melanin. The result of this increased melanin production is the formation of brown spots and freckles called lentigines. Azelaic acid is also effective for melasma or “the mask of pregnancy” due to hormonal changes that occur during gestation.

It lightens these dark spots resulting from the over-production of melanin by blocking the enzyme tyrosinase necessary for the conversion of tyrosine into melanin the pigment responsible for these spots. Studies have shown this natural substance’s ability to lighten these spots is approximately the same as that of hydroquinone, around sixty percent. The advantage of it over that of hydroquinone is that it can be used for long periods of time where hydroquinone should not be used for more than three months, it has virtually no side effects, it has not been shown to be carcinogenic in animal models, and it is available without prescription. One of the disadvantages of azelaic acid is that it may take slightly longer to lighten brown spots, and it is very sensitive to oxidation on exposure to the air. The creams and gels that are in bulk jars, tubes, or pump bottles are easily exposed to the air. This repeated exposure to the air causes the its natural ingredients to oxidize and lose its effectiveness. It is very important that consumers look for azelaic acid in sealed unit dose packaging to insure maximum potency with each use.

Another property of is its effectiveness in treating both comedogenic and inflammatory acne. Acne is caused by the bacteria Proprionbacillus acnes. These bacteria cause an inflammatory response by the skin that results in increased production of the sebum that plugs the pores trapping both the proprionbacillus as well as staphylococcus epidermidis. These trapped bacteria are responsible for the inflammation and comedones seen with acne. Azelaic acid is effective against acne because it works on many levels when in comparison to other acne products. It is bactericidal for the acne bacteria by exhibiting an anti-DNA action at the level of the bacterial nucleus. By reducing the bacteria you reduce the inflammation and sebum production giving the skin a chance to heal.

Another serious problem that is frequently seen with acne, especially in dark skinned individuals is post-inflammatory hyperpigmentation. Any condition that causes skin irritation, whether it is environmental or bacterial can result in hyperpigmentation. Azelaic acid is not only effective in reducing the inflammation by killing the bacteria responsible for acne, but as mentioned above, it is effective in reducing the hyperpigmentation associated with acne through its anti-tyrosinase activity.

This natural acid is also an antioxidant scavenger for free-radicals and does not cause photosensitivity. This makes it an ideal product that can be safely used every day.

Rosacea is a condition characterized by facial redness, pimples and pustules. It can occur at any age but is most common in the 30-50 year old age group. This condition affects mainly Caucasian males and females of NW European decent. There are four sub-types of rosacea:

Erythematotelangiectatic rosacea typified by a permanent redness of the skin that easily blushes and flushes.

Papulopustular rosacea is characterized by redness with pus filled bumps that can easily be confused with acne.

Phymatous rosacea characterized by redness and skin irregularities and nodules that can affect various parts of the face like the nose (Rhinophyma), chin (Gnatophyma), forehead (Metophyma), cheeks and eyelids (Blepharophyma), and ears (Otophyma).

Ocular rosacea associated with red, dry, irritated eyes and eyelids that itch, burn and give the sense of a foreign body being in the eyes.

Azelaic acid is an effective treatment for rosacea, especially the erythematotelangiectatic and papulopustular types of rosacea.

There is an increasing body of evidence that shows azelaic acid to be useful in treating certain pre-malignant lesions of the skin. Several human clinical trials have shown azelaic acid to be effective in treating lentigo maligno and there are a few reports for its successful use in treating isolated low grade isolated lesions of malignant melanoma.

Once in a while there exists a cosmetic ingredient that is safe, natural, and treats multiple problems at the same time. Azelaic acid is just such a product and is indeed nature’s magic bullet.

Medical care in Dubai and the UAE varies, as anywhere, from poor to excellent. The UAE has about 35-40 Government hospitals and a similar number of private hospitals although with developments like Dubai Healthcare City (DHCC), there is rapid expansion in the number of private institutes ready to fix your bones and take your blood. Additionally, there are 150 or more Primary Healthcare Centers in the UAE.

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Government hospitals in UAE often get a bad rap but in terms of medical attention, this is perhaps a bit harsh, notwithstanding the press reports of less than satisfactory medical attention. You will probably find the biggest difference between government and private hospitals is "Customer Service" for want of a better term. Dormitory style rooms rather than private hotel rooms are the norm, and staff shortages mean nurses especially, are overworked and underpaid. But you will usually get the medical attention you need, at least in Dubai and Abu Dhabi anyway. Sometimes, for major medical procedures, a private hospital will ship you off to a government hospital anyway.

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In the other emirates medical treatment might be more questionable, and it is common for residents in those emirates to go to Abu Dhabi or Dubai for medical procedures, especially major ones. Communication in English might also be difficult in more remote areas, depending on the nationalities of the doctors, nurses, technicians, and other staff. Communication in Arabic might be difficult, also dependent on the nationality of staff you're talking to - many hospitals employ doctors and nurses who might not speak any Arabic, but usually non-Arab nationalities employed all speak English, as do the majority of Arab nationalities employed, especially in Abu Dhabi and Dubai private hospitals.